Krista Caldwell, SPT and Nick Legacy, SPT
Spondylolysis is a crack or stress fracture of a section of the lower back, also known as the lumbar spine. Your lumbar spine contains 5 bones called vertebrae, and with this injury the 5th vertebrae is most commonly affected. This stress fracture can occur on one side or both sides of your body. According to the American Physical Therapy Association, this happens to 11.5% of the population in the US, and it occurs more commonly in sports requiring the athlete to bend backwards repeatedly, twist, and lift heavy loads. Does your sport require any of those movements? This injury is commonly seen in gymnasts, football players, hockey players, and dancers. It is often more common in young males. The two main causes are overuse in sports and genetics.
Spondylolisthesis describes the forward slippage of one vertebrae over the vertebrae below it. This often occurs along with spondylolysis because the bone is cracked so badly that it has difficulty staying in place. This slippage often occurs during a growth spurt.
These conditions do not always have obvious symptoms and may not be discovered until an x-ray is performed. Low back pain is the most common symptom. If you participate in one of the sports mentioned above and are experiencing low back pain here are some other symptoms to look out for:
- Pain similar to a muscle strain in the back
- Radiating pain into buttocks and/or thighs
- Worse with exercise/activity
- Better with rest
- Back stiffness
- Tight hamstrings
- Trouble with standing/walking
- Trouble with prolonged sitting
- Relief with bending forward
- If severe, possible numbness and tingling in legs
With proper treatment and adequate rest an athlete can recover from this in about 3-6 months. Most athletes suffering from a “spondy” are free from pain after treatment and return to their sport with no or few issues. This injury can be prevented through proper education to athletes at high risk (gymnasts, football players, dancers, etc.). A young athlete at risk should monitor volume, intensity, and frequency of exercise. Parents should limit athlete to one high risk sport a season, only one team at a time during season, one or two days of rest a week, and slow increase in training volume/intensity/frequency. Proper core and glute training, back strengthening, and appropriate footwear can play a role as well. Lastly, proper rest, nutrition, and hydration are important for all athletes.
Merkel, Donna, PT. Spondylolysis. Move Forward PT, Published May 14, 2014. http://www.moveforwardpt.com/SymptomsConditionsDetail.aspx?cid=493929d9-d02a-4c87-81dd-f1550a701f9e
Spondylolysis and Spondylolisthesis. American Academy of Orthopedic Surgeons. September 2016. https://orthoinfo.aaos.org/en/diseases–conditions/spondylolysis-and-spondylolisthesis